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Effect of Menstrual Hygiene Education on Menstrual Hygiene Practices among Adolescent Girls in Nigeria

Abstract

Menstrual hygiene is an important component of adolescent girls' health, dignity, education, and overall well-being. Menstrual hygiene practices refer to the behaviours adopted by girls during menstruation, including the use of appropriate menstrual absorbents, regular changing of menstrual materials, proper washing and drying practices, hand hygiene, safe disposal of used menstrual materials, and access to clean and private sanitation facilities. Poor menstrual hygiene practices may increase the risk of reproductive and genitourinary infections, discomfort, social embarrassment, school absenteeism, and reduced participation in daily activities. Menstrual hygiene education provides adolescent girls with accurate and age-appropriate information about menstruation, menstrual health, personal hygiene, appropriate use and disposal of menstrual materials, and management of common menstrual challenges. In Nigeria, adolescent girls may face several barriers to appropriate menstrual hygiene, including inadequate knowledge, cultural taboos, stigma, poverty, high cost of menstrual products, limited access to clean water and sanitation facilities, and inadequate privacy in schools and communities. These challenges may negatively influence girls' ability to adopt safe and appropriate menstrual hygiene practices. Providing effective menstrual hygiene education may improve knowledge, correct misconceptions, increase confidence, and encourage healthier practices during menstruation. Against this background, this study investigates the effect of menstrual hygiene education on menstrual hygiene practices among adolescent girls in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains health-related behaviours through perceptions of susceptibility, severity, benefits, barriers, and cues to action, providing a basis for understanding how menstrual hygiene education may encourage healthier practices. Social Cognitive Theory emphasizes the interaction between knowledge, behavioural capability, personal beliefs, social influences, and environmental factors in shaping health behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from health education may influence menstrual hygiene practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how menstrual hygiene education may influence menstrual hygiene practices among adolescent girls in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from adolescent girls in selected secondary schools in Nigeria using a structured, age-appropriate, self-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, schools, classes, and eligible participants. Where feasible, selected schools will be assigned to intervention and comparison groups. Participants in the intervention group will receive a structured menstrual hygiene education programme covering menstrual physiology, personal hygiene during menstruation, appropriate selection and use of menstrual absorbents, frequency of changing menstrual materials, handwashing, bathing, safe disposal of used materials, management of menstrual discomfort, and available sources of menstrual health support. Menstrual hygiene practices will be assessed using indicators such as type and appropriate use of menstrual absorbents, frequency of changing absorbents, handwashing before and after changing menstrual materials, bathing practices, washing and drying of reusable materials where applicable, safe disposal practices, and use of clean and private sanitation facilities. Data will be collected before and after the intervention to assess changes in menstrual hygiene practices. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, menstrual health knowledge, and hygiene practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of menstrual hygiene education on menstrual hygiene practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, and the robustness of the findings. The study anticipates that menstrual hygiene education will have a significant positive effect on menstrual hygiene practices among adolescent girls in Nigeria. Girls who receive structured menstrual hygiene education are expected to demonstrate improved knowledge and adopt safer practices, including regular changing of menstrual materials, appropriate hand hygiene, proper bathing, safe disposal of used menstrual products, and appropriate care of reusable menstrual materials. Education is also expected to correct misconceptions surrounding menstruation, reduce embarrassment and stigma, and increase girls' confidence in managing menstruation. However, education alone may not guarantee appropriate menstrual hygiene practices when girls lack access to affordable menstrual products, clean water, functional toilets, handwashing facilities, privacy, and suitable disposal systems. Household socioeconomic conditions and school infrastructure may therefore influence girls' ability to implement the practices recommended through health education. Consequently, menstrual hygiene education is expected to be most effective when combined with improved access to menstrual products, water, sanitation, and hygiene facilities. This study is expected to contribute to the literature on adolescent health, menstrual health, reproductive health, health education, and public health in Nigeria by providing empirical evidence on the effect of menstrual hygiene education on menstrual hygiene practices among adolescent girls. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, state ministries of health and education, school administrators, teachers, school health coordinators, community health workers, development partners, and policymakers regarding strategies for improving menstrual health among adolescents. The study will also provide evidence-based recommendations for strengthening menstrual hygiene education in schools, improving access to affordable menstrual products, providing adequate water and sanitation facilities, establishing appropriate menstrual waste disposal systems, reducing menstrual stigma, and integrating menstrual health education into comprehensive school health programmes across Nigeria.

Keywords: Menstrual hygiene education, menstrual hygiene practices, adolescent girls, menstrual health, personal hygiene, reproductive health, school health, water sanitation and hygiene, health education, Nigeria.